Individual
LAURA R. SANDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
303 PEARL AVE, SUITE C, OSHKOSH, WI 54901-4774
(920) 233-4557
(920) 233-5644
Mailing address
PO BOX 679, OSHKOSH, WI 54903-0679
(920) 233-4557
(920) 233-5644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6616-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39779900
—
WI
Enumeration date
04/27/2006
Last updated
12/08/2021
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